As an out-of-network provider, I do not bill insurance companies directly. Depending on your current health insurance provider you may be eligible for out of network benefits. At your request, I can provide a statement of service for you to submit to your insurance company for possible reimbursement. If you are unsure about your coverage, please contact your provider to verify how your plan compensates for psychotherapy services.

Here are some questions to ask your insurance carrier to better understand your coverage:

What is my coverage for outpatient mental health services?

What is my yearly deductible, and has it been met?

What is the reimbursement rate for an out-of-network provider?

How many therapy sessions are covered in a calendar year?

Are there any limits to my coverage?

What is the reimbursement rate for CPT code 90837 (Individual Therapy)?

If you’ve never used out-of-network benefits and would like help submitting your forms, there is an app that can help. For more information click here: https://www.getbetter.co

I do not bill directly to insurance. Payment will be due at the beginning of the day of the scheduled session. Acceptable methods of payment are all major credit cards, as well as HSA/HFA cards.

I understand that things come up, so you may cancel or reschedule your appointment with at least 24 hours notice. If your cancelation is less than 24 hours notice, you will be charged for the full rate of the appointment with the credit card you have placed on file at the onset of treatment. If cancellations and/or no-shows become frequent we will process this together as this may indicate a need for a break in therapy. Three consecutive cancellations and/or no-shows will result in termination of services. In order for therapy to be effective, consistent attendance is necessary.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit: Center for Medicare & Medicaid Services or call 800-985-3059

As a telehealth provider, I follow all requirements indicated by the U.S Department of Health & Human Services regarding the protection of Personal Health Information (PHI), under the guidelines of the Health Insurance Probability & Accountability Act (HIPAA). As a recipient of psychotherapy services, you have specific rights to privacy and access to your personal health record.